Talk:Pyloric stenosis

Hypokalaemia
Have just added an extra piece on the cause of hypokalaemia with severe vomitting. In an attempt to rectify the metabolic alkalosis, cells will exchange their intracelluar H+ ions with K+ from the blood. This is an important part of the development of hypokalaemia with vomitting. Hoganpc (talk) 15:59, 6 June 2013 (UTC)

The Picture
The scar shown in the picture with the article on HPS looks a good deal larger and scarier than is typical, I think. Nonetheless, I'm glad to have a pic there. I don't want parents who see that to be frightened, however. Anyone with a more subdued photo? Pkoetters 05:42, 15 August 2006 (UTC)

--- Interesting photo. I was operated on for Pyloric Stenosis around 11-12 weeks after birth. My scar is horizontal, not vertical as illustrated in the photo. When I look at baby photos, in all honesty mine didn't look too different. The operation was around the mid 1980s in New Zealand, so the procedures are probably different now. If I had a choice, I would have chosen a vertical scar, as the horizontal one has left a kind of hollow area, I guess you could describe it. Rather be alive with a scar than not at all. :-)

I'm the first born, male, and of New Zealand European origin (Caucasian). There is no family history of this condition, and my younger brother didn't develop it either.

[http://farm3.static.flickr.com/2202/2466048809_7ffb584fcb_m.jpg Click this link to see a horizontal scar - adult. ]

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I am a pediatrician and the picture of this scar is misleading and frightening. It would be great to remove it and replace it with something more realistic and reassuring. The current operation leaves a very small horizontal scar in the right upper part of the abdomen, probably an inch long. Parents with childen with pyloric stenosis, or possible pyloric stenosis, would be comforted to see this smaller scar...
 * I'm new to wikipedia - forgot to sign my name Queequeg804 03:31, 16 May 2007 (UTC)

glennfeole804@AOL.com and Queequeg804

The photo shows the "scar" as vertical. Mine is horizontal. At 39yrs, I am happy to finally see someone with the same scar, Mr Ferrell. Thank you for the confirmation. I appologize if my comment is not appropriate. 14:55, 7 December 2007 - 4.154.16.184

The article's photo is a bit scary but acknowledges it's of an incision at the large end of the range. I've come across a few photos of recent similar size ones however - as well as "Firebug26" below whose adult scar is only an inch long - that's almost minimal access stuff! My scar is vertical, 10 cm long - which means probably about 4 cm originally. I prefer it cosmetically to a RUQ/horizontal scar, but mine is also quite sunken and lumpy and has got more so with age. The look of a healed scar depends on the surgeon's skill and care in rejoining layers of muscle and tissue and what our living bodies do with scar tissue, adhesions etc over the years. In 1945 and it seems for a decade or two after that, incisions like mine were still closed with external stitches, the scars of which have also grown: I'm glad surgeons have long since done something about that... But, whatever the looks, for me it's a sort of war wound and a ticket to a good life.

From what I've come across, open PS surgery in the US rarely uses the midline/vertical incision while in Canada, UK and Europe it is (or was) quite common. I had my surgery in the Netherlands and know several others who've had it since - all north from the navel. I wonder if my impressions are correct, and if so, why?

Heredity
Numerous studies as well as personal observation have shown that some cases of infant pyloric stenosis occur in families with similarly relatives, but that many seem to be unique to the family. Studies (including a large one in Denmark) have shown that about 20% seem to have a familial aspect; a recent study that at least 3 gene loci may be involved. Other causes have also been identified, among them maternal stress, the mother's level of gastrin secretion, and the mother having used the antibiotic Erythromycin. What is clear is that pyloric stenosis in babies is multi-factorial.

It is said that this condition usually affects first born males in the family. I was a rare case of being a second born male with this symptom. My older brother doesn't have it. My father was a first born male (with an older sister) and had it. When they performed the surgery on him, they gave him whiskey as an infant to help him handle the pain of surgery, this was in the early 1940s. His father had an older brother (first born male) that had this and died at 6 months, which was in the first decade of the 1900s. The scar I have from the surgery is vertical and not really noticeable. My dad's scar is a bit more noticeable. The side of the family that it came from is of German descent. -- Suso 22:13, 10 October 2006 (UTC) I am a male, the youngest of a family of six children, two females five males. Nobody else in my family was born with pyloric stenosis. I am a carrier of Congenital Disorder of Glycosylation Type 1a (PMM2-CDG) and Hereditary Fructose Intolerance. My scar is vertical and unremarkable. As a child I was a very picky eater and thin; I was told by a nurse that this was common among similar children. I still do not like eating meat. I used to feel sick after eating strawberries. Now I don't but plums give me wind. The article mentions Scandinavian ancestry. I have 1.1% Scandinavian genes.

Oddity
My family has a strong case history of PS. There are eight children in my family. My oldest brother (third born), youngest brother (seventh born) and my self (female - eighth born) all had the surgery within weeks of our birth. There is also a male cousin on my Mothers side (Third child, second boy) AND my son who were diagnosised and had surgery. My scar is vertical, approximately 3 inches long. All other relatives have horizontal scars.

Apparently I am a very rare case in terms of this disease. Not only am I a female, but there are apparently no other people in my family, in current history, that have had it. I have just recently started really looking into the disease to see what it is. Like one of the other commentors, my scar is also horizontal, unlike the picture in the article. I do have to agree that I probably would have preferred the vertical scar as there is a sort of hollow space from this particular scar.

I'm also an oddity. I'm a first born female and the first in the history of the famliy to have this. I was not diagnosed for weeks and nearly died. When my first sister was born, my mother recognized the signs, but was told it was impossible that two FEMALES would have it in the same family... until she projectile vomited across the room. My second sister was also born with it, but she had a milder case that caused indigestion and colic. The surgeon who performed the surgery on me and my first sister came out of retirement to perform surgery on my second sister. She had an umbilical hernia from the colic making her cry so hard; so her scar doesn't match mine and my first sister (both vertical). - Alisha 3/28/07

My family is another slight oddity: I had pyloric stenosis in 1937 and have a large vertical scar. We were told that PS was characteristic of first-born males of Jewish descent (which I am). My son did not have it, but my daughter (second-born) did in Poughkeepsie, 1965. I asked the surgeon to give her a horizontal scar as I heard that this left the smallest mark, and she might want to wear bikinis. She has since been very appreciative that we suggested that. What was strange is that I was told there were a cluster of cases right about that time in the mid-Hudson valley, which was apparently much higher than the average incidence. Jpaulm (talk) 19:22, 7 December 2007 (UTC)

I am another case of a first-born female and the first in family history to be diagnosed with PS. My parents took me to the hospital on base because I was projectile vomitting. The doctors kept sending me home with colic. After a week of continuous vomitting, and dropping 2 lbs., my parents took me to a different hospital. They immediately put me under the knife at six weeks old. I also have a one inch horizontal scar mid-abdomen. I am now 23 yrs. old and finally researching this condition. I have one question that remains unanswered, though. I want to know if there are any long-term affects from the condition and/or surgery? I suffer from a minor case of Acid Reflux as far back as I can remember. Can this be related to PS? Feel free to email me at NLTL2000@aol.com. Thank you. Firebug26 (talk) 16:20, 16 January 2008 (UTC)

Are there definite ongoing after-effects from PS or the surgery? I've wondered this for years (albeit as a layperson) and have come across only one limited study, which probably means it's not a major issue for the medicoes. In 1994 Sydney's Westmead Children's Hospital reported on 85 children who'd had pyloromyotomies in 1984-91. It found few gastric problems, no significant pain, but 2 had significant vomiting and one colic. It also found that almost 25% of the 85 had a family history of PS (more than generally believed).

On the other hand, teenage and adults with a HPS history who go public mention quite a list of complaints incl. overeating and obesity, hunger and a fast metabolism, scar and stomach sensitivity and pain, abdominal muscle spasms, weakness and reflux. I suspect most of this may be non-PS related. I've noticed a few of these things too, but only mildly - and many others would also be able to tick some of these issues. Because of my PS history, I'm also more alert to anything unusual in this area. So what's real and what's in the mind? If something really bothers me I check it out on the Web and if need be speak with my GP. Fredvanderbom (talk) 12:11, 17 February 2008 (UTC)

I think my case was considered a rare case. Not only was I born with PS but my twin brother had it as well. The only problem either of us has had so far with this was that his scar tissue in some way fused with his abdominal muscles and started to reopen his scar. He had to get cosmetic surgery to fix this. I have started to have muscle spasms around the scar recently so I wonder if this is anyway related. —Preceding unsigned comment added by 222.64.103.173 (talk) 04:20, 10 April 2008 (UTC)

I too am a female who had this at birth- I am first born, and it was in my father's side of the family- his brother, who was second born had it. He had an appendicitis at a young age, however. The doctors at William Beaumont Army Medical Center were not much help at first, they diagnosed me with a "bad cold"- luckily a visiting physician overheard my parents saying they would not leave until they found out what was really wrong with me- he immediately after hearing my symptoms checked me for pyloric stenosis, got me hooked up to an iv since I was dehydrated (I still have the scar on my ankle from this) and then once stable performed the surgery. I have a rather large horizontal scar on the upper right quadrant of my stomach and I agree with the other posters about the "dent" that has formed. It's not pretty. But, also agree about better to be alive with this scar than the other option! I have suffered with heartburn for a long time too. I don't know if they are related or not. Kerrie, Huntsville, AL —Preceding unsigned comment added by 130.76.96.23 (talk) 17:48, 30 January 2009 (UTC)

Famous sufferers
Though such information can obviously be of interest particularly to sufferers/relatives, it needs careful referencing to reliable sources. It might be best to stick to celebrities who have themselves publicised their condition through eg charity work. Espresso Addict (talk) 09:11, 1 February 2008 (UTC)

Warnings for Parents
Forceful ("projectile") vomiting is the best-known symptom of pyloric stenosis, but this does not always occur and is not always consistent. The condition may progress to the critical stage over a few days or over some weeks, and very soon after birth or up to 5 or six months later; the majority of cases develop between 3 weeks and 3 months. Weight loss may be anywhere between severe and negligible. Dehydration and malnutrition can occur quickly when a baby is suffering from pyloric stenosis and are each critically dangerous. Parents can notice signs of these if their baby cries without tears, has less or no wet or dirty nappies, or becomes shrivelled in appearance and listless in behaviour. Medical tests (ultrasound and xray) do not always indicate pyloric stenosis at first, and all symptoms must be taken into account in diagnosis.

long term effects
I had PS operation in 1966 and I am female. The only op available at that time was vertical and is very like the scar in the picture. You have to remember the scar looks terrible because the baby is small.There ARE long term effects. I have adhesions around my kidney ,liver and intestines which causes discomfort. It also stopped me having keyhole surgery for removing my gall bladder. My gall bladder operation lasted 3hours long because of the adhesions. — Preceding unsigned comment added by 31.49.92.66 (talk) 14:15, 19 June 2016 (UTC)

Merger proposal
see Talk:Gastric outlet obstruction
 * Was a bad request based on wrong link in wikidata which is now fixed.